In surgical practice, deciding on the right type of surgical access for a specific condition would be a skill of its own for a surgeon. The decision to select a specific incision would depend on the several elements. These would be,
Problem site Related anatomical structures Easy access Less complications Quicker healing Minimum scar
But, at instances, all these options might not be fulfilled and the surgeons have to make a professional judgment as to decide on what’s best for the patients’ condition and act fast in order to save the life of the patient.
Out of many areas in the body, abdomen could be one area which sees many surgical incisions for different kinds of surgical necessities. This article will discuss predominantly on abdominal incisions and its uses in surgical practice.
1. Grid iron incisions
Also known as ‘McBurneys incision’, the incision is the most commonly used incision for ‘appendicectomy’. The incision will be placed at the McBurney’s point which is at the junction between the middle one third and the outer one third of a line extending from umbilicus towards the anterior superior iliac spine. It’s commonly places obliquely and has the potential to be expended in case the need arise.
2. Pfannansteil incision
The incision is the usual procedure adopted for surgical access towards pelvic organs and mainly for cesarean sections. The incision is placed horizontally about 5 cm above the pubic symphysis and is about 12 cm in length.
3. Kocher subcostal incision
The incision is placed below the costal margin or the lower margin of the rib cage and could be on either left or in the right. But, most often the incision will be placed on the right side of the body to gain access to the gall bladder and the billiary tree.
4. Mid line incision
The incision placed on the middle of the abdomen will run vertically and will give the surgeon enough access to almost all abdominal organs and will facilitate good visualization as well. There are several advantages of this kind of incision and being blood less plain is one of the most important. This incision is widely used in surgeries related to bowel pathologies and especially in situations which require the necessity to remove part of the bowel.
Paramedian incisions are also used when the need arise to access certain organs towards a particular site.
Cheveron incision and Mercedes Benz Modifications are some of the other incisions which will allow the surgeons better access to upper abdominal organs.
Apart from these, it is vital to remember that a surgeon will be able to make a decision based on his clinical experience on the placement of the incision as well as the required size of the incision. Therefore, the art of doing a surgery would not be limited to text book patterns of incisions, but you can be assured that the above described incisions will account for many of these decisions.
